The phone rings in my office. A mother is calling about her teenage daughter or son who is, at this early age, struggling with being overweight or obese. Sometimes the teenager already has high cholesterol or even high blood pressure. This is unfortunately becoming too commonplace. Adolescent obesity has been linked to depression, anxiety, suicidal thoughts, poor self-esteem, attention deficit hyperactivity disorder (ADHD), aggressive and destructive behavior, binging and purging, and other severe emotional outcomes (Reinehr 2018). Many parents and their teenage children become desperate for solutions. After all, with the social stigma obesity carries, this is a true problem needing an answer. But desperate measures don’t bring positive results!
Desperate for help, many teens and their families will try anything to lose weight. Their feelings are justified — without intensive intervention, 90% of obese teens will be overweight or obese as adults. They also face increased risk for type 2 diabetes and insulin resistance, sleep apnea, fatty-liver disease, high cholesterol, hypertension, hip dysfunction, and polycystic ovarian syndrome-PCOS (in females) (Steinbeck et al. 2018). And so, people tend to do the wrong things; the things that have proven ineffective.
The very first option people think of is the failed diet “solution.” They don’t work, they’ve never worked and it is a mentality that we need to abandon both for teens and adults. In addition, there are the companies that want to take advantage of the problem. In the United States, recently Weight Watchers offered a free weight loss program for teens. Weight loss companies like Medifast® and OPTIFAST® have developed teen-focused programs with calorie-controlled meal plans that require purchases of shakes and other processed foods. Weight loss camps—generally costing $5,000–$10,000 for programs of 2–12 weeks—promise teens rapid weight loss, often with little medical oversight or evidence of long-term effectiveness. Unfortunately, some of these kids end up eating disordered from some of these methods. We need to use an approach that will bring a long-term result and help our teens develop good health habits for the rest of their lives.
Communicating with teens
Adolescence is a vulnerable life stage with new social norms and pressures. Teens’ impulsive behavior, quick-fix outlook, growing independence and potential defiance can make any attempt to influence their health seem overwhelming. The first step is to gain a teenager’s confidence. Focus on changing behaviors and habits, and not on losing weight or the significance of the numbers on the scale.
Instead of restricting calories, start with 5 behavioral changes that will make a big difference:
- Eat “real foods” like vegetables, fruits and whole grains rather than packaged or highly processed foods.
- Incorporate enjoyable activity into each day.
- Get adequate sleep.
- Limit time from computer screens and devices for part of the day.
- Cope with stress more effectively.
Teens must be able to experience the rewards, including improved mental and physical health and well-being, that result from these behavior changes. Teens are not like the rest of us. Adolescents are not young versions of adults. Thus, optimizing health and treating obesity in teenagers means tailoring programs to their age, developmental stage, personal preferences and aspirations. Moreover, this work must be done by a caring team of medical and health professionals who understand adolescents.
The role of parents in this process is critical. Research has found that parents who urge a child to diet may do more harm than good: “Experiencing parent encouragement to diet as an adolescent was significantly associated with a higher risk of overweight or obesity, dieting, binge eating, engaging in unhealthy weight-control behaviors, and lower body satisfaction 15 years later” (Berge et al. 2018). Instead, parents can help by modeling healthy habits and a healthy relationship with food for the whole family.
I once worked with a teen who was in his last year of elementary school. His parents couldn’t understand that even though he was the only child in the house that needed to lose weight, he shouldn’t be singled out. For instance, while sitting around the table with his siblings for an afternoon snack, while everyone was eating chips and drinking cola, he was expected to refrain. Parents have to be role models. Even if siblings will eat the way they eat, the parents need to model proper behaviors for all of their children. If you expect you kids to eat healthy and get some exercise, you need to do the same.
Making it practical
When it comes to modeling and encouraging our teens to lose weight, here are some simple do’s and don’ts as suggested by Dr. Natalie Digate Muth, who is a pediatrician, dietician and personal trainer.
- Make family meals a priority
- Encourage a child to eat when hungry and stop when full
- Eat a wide variety of nutrient-dense foods
- Provide ready access to fresh fruits and vegetables
- Remove unhealthful “trigger” foods such as ice cream, potato chips and sugary drinks from the home environment
- Make healthful changes for the whole family
- Incorporate physical activity into everyday routines
- Get adequate sleep and enforce bedtime routines
- Set computer/screen time rules for the whole family, such as no screens during mealtimes or within 1 hour of going to bed.
- Demonize foods
- Punish teens for “poor” nutrition decisions (with exercise or otherwise)
- Use food as a reward (such as eating your vegetables to get dessert or celebrating a good report card with ice cream)
- Single out an individual family member
- Eat for emotional reasons (stress, anxiety, etc.)
- Make negative comments about a child’s body or your own
- Tease about weight
When speaking to a teen about weight loss, it is incredibly important to discuss in an adult fashion the true dangers of being overweight and obese. Just like we teach our children to wear a seat belt in a car for their own safety, in a delicate way, the dangers of obesity should be made known.
Know what to say
First, be informed and research this subject. After talking about the different risks involved, engage your child, or friend, in conversation about each point. Make sure he or she understands the ramifications of each disease or problem and the resultant lack of quality of life. Here are some points to discuss:
- Type 2 diabetes and insulin resistance
- Sleep apnea
- Fatty-liver disease
- High cholesterol
- Hip dysfunction
- Polycystic ovarian syndrome (in females)
- Depression, anxiety, and low self-esteem
- Attention deficit hyperactivity disorder
- Aggressive and destructive behavior
- Computer related addictions
- Eating disorders like binge eating and purging
Even with all the facts and figures in hand to discuss, it always will come down to changing habits and behaviors in order to get the desired results. It is essential to empower our adolescents and encouraging them to be successful. The first step is to set goals and make sure they are reachable and realistic. Give your child the autonomy and the tools to make healthy choices. A normal and doable goal such as, “I will eat a fruit or vegetable with each meal or snack” is much better than saying I will lose 1 kilo this week. These tactics set teens up for the quick wins that will keep them motivated.
Once teens develop goals, encourage them to learn new skills like reading nutrition labels, understanding serving sizes, noting hunger and fullness cues, and helping with meal planning. These skills can keep teens involved and achieve their goals.
Another way to empower teens is to let them attend health or fitness appointments on their own, without a parent. I usually ask the parents to come to the first visit or two but after that I prefer to see the client alone.
Keeping our households healthy is imperative for good health and quality of life. If we do have an adolescent who is struggling, we should take action, but we need to take the right and proper steps to help them succeed and “add hours to your day, days to your year and years to your life.”